GERD after the Vertical Sleeve Gastrectomy (Gastric Sleeve)

by Waning Woman
(Dallas, TX)

I underwent the VSG, Gastric Sleeve, in February of 2010. Other than an incident with dehydration, my first few months were free of physical side effects.

Around month three or four, I experienced an episode of choking upon my stomach contents while sleeping, but I thought that was just because I'd eaten too close to bedtime. In fact, I'd eaten in the bed and went right back to sleep.

A few weeks later, I noticed that I was having heartburn a few times a week. Up until that point, the only time I'd ever had heartburn in my life was during my pregnancy.

I took a few over-the-counter antacids, but that didn't seem to help. The heartburn kept getting stronger and more frequent, so I tried acid reducers like ranitidine, cimetidine, etc. Eventually, it got to the point that the only thing that would manage my symptoms was Prevacid, a proton pump inhibitor (ppi).

As long as I take my ppi daily, my symptoms of GERD are pretty much under control. Not eating within an hour and a half of bedtime and sleeping with my head elevated have also helped with my symptoms.

If you're experiencing acid reflux or GERD after your Vertical Sleeve Gastrectomy, you're not alone.

Related Pages:
- Bariatric Surgery Complications & Side Effects
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)

Comments for GERD after the Vertical Sleeve Gastrectomy (Gastric Sleeve)

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Stomach acid post-surgery
by: Molly K.

I too have had excess stomach acid and even some vomiting of stomach acid. I often wake up with burning stomach contents in my mouth. It is so bitter and sour that I'm afraid it will dissolve my teeth!

I tried all the over the counter antacids too. Nothing was strong enough to really quell the acid and keep it neutralized for more than a half hour or so. Besides, taking pills or capsules of any kind make me horrendously nauseated and often cause me to vomit. Not good for a new Sleeve!

The PPIs, like Prevacid and Prilosec can cause severe osteoporosis with extended use, so I am afraid to take them every day. Being an older female, I already have weak bones and I sure don't need a broken hip on top of everything else.

Because I had my surgery in Mexico, I had no one to follow up with. I finally consulted two local Gastroenterologists, and neither one was any help at all. They ignored me when I told them I can't take pills without usually vomiting. They just gave me a blank stare and told me to "take pills." A total waste of money to see both of those "specialists."

My best remedy to date is Liquid Zantac. It is a syrup, you only need a teaspoon full, and it is very easy to swallow. I have never thrown it up. It stops the acid immediately and seems to last longer than any of the pills did. It doesn't make me nauseous, either. Best of all, it is a H2 blocker, so it doesn't rob your body of Calcium, you can pretty much take it as often as you need it.

I am having excellent results with this product. It is really cheap too... a huge bottle is $4.00 with a prescription. If you can get your hands on this product, I highly recommend it for persistent and serious acid.

Best of luck to you, dear. I am finally feeling better and for the first time, not sorry I did this to myself!

Thank you
by: ChuckAnn

Thanks for your insight. I'm having surgery in 4 days and am being obsessive about getting as much info as I can re problems before I encounter them! For once my OCD is really going to pay off. :-) I have complete confidence in my surgeon but not in myself to stay calm and be prepared. Thanks again!

7 months post- op with GERD
by: Anonymous

I'm experiencing GERD. I've been on the recommended postoperative antacid, however I'm still having trouble with it. I see my Bariatric Nurse Practitioner this week, hopefully we can find something to help!

It's bothersome, and has made me think that perhaps I should have gone with the RNY vs the sleeve... Can't change this now, and I sure hope I find a med that works! On the flip side I'm no longer diabetic nor do I have hypertension!!! Once I get this gerd under control I will be a happy sleevester again :D)

reflux still 7 months after surgery
by: Anonymous

I had a vertical sleeve in dec. I am loosing too much weight. I have constant pain in my throat and chest. feels like something is stuck in the middle of my check and hurts through to the back area. I have severe reflux at times, where after eating 6-8 hours later I will wake up with stomach acid coming out of my mouth. this will send me into coughing spasms. I now have light coughing spasms which are hard to control more frequently. My Dr. was going to check on possibly having my sphincter checked, but its been two weeks and have not heard from him. I have lost a lot of weight and have no muscle. I look malnourished and feel that way also. I have a hard time drinking and eating. I have tried to increase protein but with the pain its not working. I take the proton pump meds, I can't even imagine what it would be like if I didn't. Any one had this bad of a problem and found relief. the dr says I may need a revision to gastric bypass. I have lost a lot of my hair, my skin looks awful..I have regrets about the procedure.

Coughing and choking in GERD patients
by: Shivaree

I am awaiting gastric sleeve for GERD and gastro paresis I see by the posts that it is not a sure thing, but to the anonymous post about the coughing and choking...for 2-3 years I had chronic cough and was diagnosed with and treated for bronchitis repeatedly...the treatment would work for 2-3 weeks and right back to coughing again. I decided to go see and lung doctor and lo and behold in 5 minutes he had the answer, I was having Fungal Lung infections from the GERD acid coming up my esophagus. Once treated with anti fungals it appeared less often but the GERD and slowed digestion does cause it to come back. Also and endoscopy revealed Barrett's esophagus which I believe causes all the choking and feeling of an obstruction in my wind pipe or throat. Check with your doctor or a lung specialist to check for fungal lung infection or the Barrett's' esophagus. If the Barrett's esophagus becomes severe enough there is a surgery that can be performed but I was told they have to get the GERD under control before considering the surgery. I wish you luck and hope this information was helpful to you.

Acid reflux gastric sleeve
by: Anonymous

I had my procedure done in Mexico in August 2011. Due to persistent acid reflux, I was recommended to return to Mexico for a replication. Didn't notice any difference in reflux..no follow up from dr either. Pretty scary! I purchased an adjustable bed and gave up chocolate, wheat and caffeine. It helped significantly, but I continue to take a Zantac max strength every night before bed. Went to Germany in October and started eating everything again although in small quantities and I can't get through the day without a Zantac and I wake up at night choking on acid. I recently started tasting blood..so I'm concerned but drs don't seem to care since they didn't do the surgery...

Response to GERD after Sleeve
by: Marc Bessler, M.D. Professor of Srgery, Columbia University, NY

Dear Waning Woman,
Perhaps the biggest problem with sleeve gastrectomy is that it can aggravate GERD in those who have it and cause GERD in some who don't. It is believed that the increased pressure in the stomach after sleeve is part of the cause but also the anatomy of the stomach adjacent to the lower esophageal sphincter is change during the surgery. Often reflux improves over time but for some that is not the case. If medications control symptoms, quality of life is good and there is no change in lining of the esophagus there is no absolute need to do anything. Some however will not want to take daily medication, develop Barrett's or inadequate weight loss. In those cases, careful evaluation is advisable. A barium study to evaluate the anatomy of the sleeve can help. A hiatal hernia that was not seen at the initial operation or that develops afterwards can be one cause. One option that will eliminate reflux in 95% of patients is revision to gastric bypass.
Anyone with Barrett's should seriously consider avoiding sleeve gastrectomy and having a gastric bypass instead. Those with reflux that is not well controlled or who do not like taking the medication and lifestyle changes required to control reflux should discuss options with an experience bariatric surgeon.

I hope this helps.

Marc Bessler, M.D., FACS, FASMBS

long island bariatric surgeon

(click here for Dr. Bessler's full bio & contact info)

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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.


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